After extraction, severe hard and soft tissue alteration takes place within the affected site of alveolar ridge.¹ The three dimensional resorption process at extraction sites results in narrower ridges and reduced vertical height and lingual/palatal shifting of their long axis. Most of the dimensional alterations take place in the first 3 months following tooth removal.²   

In the first 12 months after extraction, the height of alveolar ridge can diminish upto 50% because the alveolar bone resorbs especially on the buccal aspect.³  This change may lead to esthetic and functional disadvantages that compromise future implant placement particularly if the dental implant placement needs to be delayed for 6 months or longer.

Hence it is crucial to preserve the dimensions and contour of the alveolar ridge after tooth extraction to achieve a predictable esthetic and functional prosthetic restoration.

Preservation of the residual alveolar socket at the time of tooth extraction has been evaluated in many studies.  Clinical, histologic and radiographic studies documented positive socket healing responses with autogenous bone, alloplasts and xenografts, whereas others reported poor results with bovine bone, decalcified freeze dried bone & autogenous bone.^{1, 4, 5, 6, 7, 8}

Since they are associated with varying amounts of vital bone socket fill, comparison studies are useful to determine the amount of socket preservation that occurs with each material. A new class of alloplast materials, namely, calcium phosphate cements (CPC) raised certain hopes in periodontal repair in the early 1990s.  These are aqueous based cements that get converted to hydroxyapatite upon setting.  The combination of biocompatibility, osteoconductivity and restorability makes it a unique material for grafting bony defects.⁹

Platelet rich fibrin (PRF) is an autologous preparation of concentrated platelets created by centrifugation of a patient’s blood.  The use of PRF during surgical procedure is a current treatment concept used to accelerate wound healing and tissue maturation.  It can be used directly as a clot or after compression as a strong membrane. ¹⁰  

Based on these positive findings of calcium phosphate cement and platelet rich fibrin, the purpose of this study is to compare clinical and radiographic [Cone Beam Computed Tomography (CBCT)] outcomes following grafting for post extraction ridge preservation in sites treated with platelet rich fibrin with or without calcium phosphate cement.

Aim:

To compare the use of platelet rich fibrin (PRF) with and without calcium phosphate cement in fresh extraction sockets by clinical and radiographic analyses.

Objectives:

1.  To evaluate horizontal and vertical ridge changes associated with PRF used with and without CPC at baseline and after 6 months using clinical and radiographic methods.

2.  To compare horizontal and vertical ridge changes associated with PRF used with and without CPC using clinical and radiographic methods.

3.  To evaluate and compare the radiographic density changes associated with PRF used with and without CPC.